Morales: PhilHealth investigating 20,000 fraud cases

MANILA, Philippines — The Philippine Insurance Corp. (PhilHealth) is currently investigating some 20,000 cases of fraudulent transactions, its president told a Senate investigation on Tuesday.

According to PhilHealth president and CEO Ricardo Morales, the agency has hired additional investigators to help resolve the cases.

“We have 20,000 cases, 12,000 of them are in the regions. Ito ho ‘yung mga potential fraud so we have to look at every case,” Morales said in response to queries of Senator Sonny Angara during the Senate committee of the whole investigation into corruption claims hounding the state health insurance firm.

“We might need to do a forensic audit to be able to find out where exactly this is because it doesn’t appear in the books…itong loss to fraud. It has to be a focused forensic audit [to determine] kung saan po napunta itong fraud na ito,” he added.

Earlier in the hearing, Morales told senators that PhilHealth “potentially lost” around P10.2 billion in 2019 to fraudulent transactions and schemes.

This loss could balloon to P18 billion by next year if not addressed properly, he added.

“Healthcare is prone to fraud even in other societies because hindi natin mataanggal yung face-to-face transaction nung pasyente at saka ng physician. ‘Pag nagkasundo po yung pasyente saka yung physicaian, e lagot ho yung healthcare insurance diyan,” Morales said.

“Kahit na sa mga advanced na bansa na akala natin ay narereduce nila ito, ay meron pa rin healthcare fraud,” he added.

Recent allegations of corruption hounding PhilHealth regarding its “overpriced” IT project has put the agency on scrutiny of lawmakers yet again.

READ: Senate opens probe into PhilHealth ‘corruption’ mess

Last year, the Senate blue ribbon committee, led by Senator Richard Gordon, investigated alleged “ghost” dialysis treatments and other irregularities that defrauded the agency of billions of pesos in previous years.

KGA